Risk stratification for recurrent tachyarrhythmias in patients with paroxysmal atrial fibrillation and flutter: role of signal averaged electrocardiogram and echocardiography.
The value of signal-averaged P-wave electrocardiogram and echocardiography for predicting recurrent atrial tachyarrhythmias was prospectively investigated in 60 patients presenting with paroxysmal atrial fibrillation or flutter. All patients were followed up for 1 year after restoration of sinus rhythm. A stepwise discriminant function analysis was used to identify variables predicting recurrent atrial tachyarrhythmias. Analyzed variables included signal-averaged P-wave duration in 3 bipolar orthogonal leads (X,Y,Z) and their vector magnitude, as well as left and right atrial dimensions and volumes. During follow-up, 25 patients had recurrent atrial tachyarrhythmias, while 35 did not. Using discriminant function analysis, the left atrial antero-superior dimension was found to be the only variable predicting the recurrence of atrial tachyarrhythmias (p < 0.0038) and was able to correctly classify 65% of the study patients. It was concluded that, in patients with paroxysmal atrial fibrillation or flutter, the traditionally used determination of left atrial dimension was the variable most closely associated with a high risk for recurrent tachyarrhythmias. The signal-averaged P-wave duration did not improve tachyarrhythmia prediction.
Turitto
G
G
Division of Cardiovascular Medicine, State University of New York Health Science Center at Brooklyn 11203, USA.
Bandarizadeh
B
B
Salciccioli
L
L
Abordo
M G
MG
Pizzarelli
M
M
el-Sherif
N
N
D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000453:epidemiology*; D001282:Atrial Flutter / Q000175:diagnosis / Q000453:epidemiology*; D016002:Discriminant Analysis; D004452:Echocardiography; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012008:Recurrence; D018570:Risk Assessment; D012815:Signal Processing, Computer-Assisted; D013997:Time Factors